Better treatment sought for mentally ill inmates

Fair says state 'can't wait' for change after judge's ruling

Jan. 11, 2014

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Staff writer

COLUMBIA — Some legislative leaders want the state to begin improving the treatment of seriously mentally ill people in the state’s prisons in the wake of a scathing judge’s order, even though prison officials have announced they will appeal the ruling.

Lawmakers told The Greenville News they have lots of questions for the Department of Corrections over the judge’s ruling but believe the state shouldn’t wait for the courts to order every change before taking some action.

Rep. G. Murrell Smith, a Sumter Republican who chairs a House Ways and Means subcommittee that deals with the Department of Mental Health, agreed.

“One thing I would be a proponent of is trying to get out in front of this issue rather than doing it with a gun pointed at your head,” he said.

Circuit Judge Michael Baxley last week found that the state’s prison system has repeatedly violated the rights of seriously mentally ill people, in some cases resulting in their deaths, and ordered the agency to develop a plan of improvements.

His 45-page order included individual horror stories, including cases in which inmates were placed in solitary for years, strapped into restraining chairs in painful positions and left naked and in filth in cold, empty cells.

The prison system issued a three-sentence statement in response, saying it would appeal.

On Friday, it provided The Greenville News a list of steps it has taken or will take to improve mental health treatment of inmates.

The agency said it will consult with state Department of Mental Health officials and request an evaluation of the prison system’s policies and procedures.

It said it is using $1 million in funding to hire more mental health staff; provide training to staff to become licensed mental health counselors; provide additional coverage for telepsychiatry services and equipment; and to develop specialized programming for mentally ill offenders to reduce the time they spend in administration segregation.

Since November 2013, the agency said, it has worked with the National Alliance on Mental Illness to strengthen training of officers.

In 2008, the agency said, Perry Correctional Institution near Piedmont created a separate dormitory for mentally ill inmates, a practice that has been replicated in two other prisons. In 2009, the agency reviewed and revised its disciplinary procedures for mentally ill inmates.

Baxley’s ruling stems from a 2005 class-action lawsuit filed against the agency by the nonprofit group Protection and Advocacy for People with Disabilities Inc., on behalf of inmates who are seriously mentally ill.

Baxley estimated about 17 percent of the prison system’s 23,000 inmates have serious mental illness, a number higher than the estimate of prison officials. In addition to finding a disproportionate use of force against mentally ill inmates, Baxley found many have been placed in segregation for years.

He also found the prison system doesn’t have enough mental health professionals on staff, doesn’t keep adequate records and doesn’t adequately supervise, evaluate and dispense psychotropic medications.

Fair said he believes the improvements will cost the state millions of dollars but he hasn’t seen any official estimates. Officials have been discussing improved treatment of mentally ill prisoners since at least 2000, when a report described the prison system’s mental health program as in “crisis” and estimated some short-term costs at about $12 million.

Rep. Leon Howard, chairman of the House Medical, Military, Public and Municipal Affairs Committee, said the cost of properly treating the seriously mentally ill will be expensive because the state has neglected their treatment for so long.

“It’s like anything else, if you don’t do maintenance along the way, you’re going to have to spend it all at one time,” he said.

Howard, a Columbia Democrat who has served in the House since 1995, said he heard some of the allegations mentioned in the ruling when he first came to office but thought the prison system addressed the problems. He said he is “shocked at the magnitude” of the allegations.

“I agree with the judge’s ruling,” he said. “It’s fair to people to be humane. While the state is spending money appealing and resisting, I think our money would be better spent trying to correct the problem.”

Baxley said the prison system had fought the lawsuit “tooth and nail” and should now consider using money it would spend on future legal battles over the lawsuit for improving inmates’ mental health treatment.

Some lawmakers said they knew nothing about the case until the ruling was issued last week.

“It came out of left field,” said House Majority Leader Bruce Bannister of Greenville. “I didn’t even know it was an issue that anybody was addressing.”

Now that it has surfaced, he said, the Legislature may “do a lot of research and investigation into how we are treating the mentally ill in the prisons.”

Those on budget committees say they will have to wrestle with how to pay for any improvements.

Baxley ordered the agency to develop a plan of change within six months to include screening and mental health treatment programs; a plan to employ sufficient mental health professionals; a plan to maintain treatment records and administer psychotropic medication with appropriate supervision and periodic evaluation; and a program to identify, treat and supervise inmates at risk for suicide.

Smith and other lawmakers said the Department of Mental Health will be involved in any improvement plan.

“It’s certainly not something I anticipated,” Smith said. “We were dealing with the restoration of Mental Health. It’s probably sustained one of the largest budget cuts since 2008, percentage wise, and we’re trying to put them back into a position where they can deliver services to the people of the state. This is going to be another road block to their overall mission.”

Rep. Mike Pitts, a Laurens Republican who heads a House budget subcommittee that oversees the prison system, said he thinks it will be an expensive issue to address, just as it has been to address the issues of placing inmates with AIDS in the general population and the issue of housing and treating violent sexual predators.

Pitts said the state would have been better served to have increased its spending on mental health in general, where some of the problems now in the prisons could have been addressed in the community.

“If we dealt with the mental health issue on the front side, we would have far less of a mental health issue in the prison system,” he said. “And I think it would be less expensive in the long run to deal with it on the front side.”

Pitts said the state also needs an alternative for mental health patients, such as the former state hospital, “which is where a lot of people need to be instead of in the prison system.”

Joy Jay, executive director for Mental Health for America in South Carolina, who was appointed guardian of the mentally ill inmates in the case, said she agrees with Pitts that the state needs more mental health resources overall and how the mentally ill are treated early determines whether they wind up in prison.

“It is the door you go in,” she said. “When you are a young person who is diagnosed with a mental illness, you either go in that corrections door or you go in that mental health door. And which door you go in changes your life completely.”

Sen. Thomas Alexander, a Walhalla Republican who oversees a Senate budget subcommittee that handles the Mental Health Department, said he thinks lawmakers need more information about the case.

“It’s going to take all parties coming together to even get a handle on understanding what the order is,” he said. “And then let the legal process work in the meantime.”

Fair, who also heads the Senate budget committee dealing with the prison system, said what the judge found is “a serious problem.”

“It is tied to funding,” he said. Fair said he wants to know what services are being offered for mentally ill inmates and if the in-house reporting of those services has been accurate.

He also said if what allegedly happened in the case of one inmate, Jerome Laudman, detailed in Baxley’s ruling, was true, someone should have been disciplined.

Baxley wrote that Laudman, who has schizophrenia and a speech impediment, was transferred to a solitary cell after being sprayed with chemical munitions, physically abused and stripped naked.

More than a week later, Baxley wrote, he was observed lying in his own vomit and feces with 15 to 20 trays of rotting food around him. He later died at a hospital from a heart attack, and a hospital report noted he had suffered from hypothermia, Baxley wrote.

“There is no excuse for that,” Fair said. “People’s heads should have rolled on that one.”

Gloria Prevost, executive director of the Protection and Advocacy group, said she hopes lawmakers begin improvements in the prison system without waiting for the appellate process to end.

“We have been talking about this for years,” she said.

“I think it would be so important for the leadership of South Carolina to step up and start moving, regardless of what is happening in court. It would make a major difference in the lives of individuals in the short run and in the long run it would make a major difference in public safety in the community and how we choose to spend our money.”